What Happens When Doctors Share Notes With Patients

Patients across the country are voicing a growing desire for greater engagement in, and control over, their own medical care. A new study led by Beth Israel Deaconess Medical Center (BIDMC) will examine the impact of adding new layer of openness to a traditionally one-sided element of the doctor-patient relationship - the notes from patients’ doctors’ visits.

That premise is based in part on a recent study by Delbanco and Jan Walker, RN, MBA, Instructor in Medicine in the Division of General Medicine and Primary Care at BIDMC and Harvard Medical School. Reporting in the Journal of General Internal Medicine (JGIM), Delbanco and Walker found that consumers want full access to all of their medical records and are willing to make some privacy concessions in the interest of making their medical records completely transparent.

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The study also found that, going forward, consumers fully expect that computers will play a major role in their medical care, even substituting for face-to-face doctor visits.

“We learned that, for the most part, patients are very comfortable with the idea of computers playing a central role in their care,” Walker says. In fact, patients said they not only want computers to bring them customized medical information, they fully expect that in the future they will be able to rely on electronic technology for many routine medical issues, she says.

“Doctors have strong differences of opinion about this, but there is almost a religious character to the debate – it’s uniformed by evidence,” says Stephen Downs, an assistant vice president at RWJF and member of the foundation’s Pioneer Portfolio, which supports innovative ideas and projects that may lead to important breakthroughs in health and health care. “It’s a subtle change – but it could reposition notes to be for the patient instead of about the patient, which might have a powerful impact on the doctor-patient relationship and, in the long run, lead to better care.”

To collect evidence, physicians and patients will fully share, through a simple one-step intervention, all encounter notes. By contrasting the experience of trial participants with unenrolled physicians and patients, the researchers hope measure the impact of notes access through online surveys of both doctors and patients.

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